Related Papers
Journal of Managed Care Pharmacy
Budget impact of introducing tildrakizumab for the treatment of moderate to severe plaque psoriasis in the United States
2018 •
Alan Mendelsohn
Cost-effectiveness and budget impact of tildrakizumab for the treatment of moderate to severe plaque psoriasis using 2019 drug costs
2019 •
Alan Mendelsohn
Journal of Managed Care Pharmacy Jmcp
Sensitivity of administrative claims to identify incident cases of lung cancer: a comparison of 3 health plans
Journal of medical economics
Treatment patterns among patients with psoriasis using a large national payer database in the United States: a retrospective study
2018 •
Kalyani Sonawane
Characterize treatment patterns of psoriasis patients in a large U.S. managed care database. Adults with newly diagnosed psoriasis were identified from 07/03/2006-08/31/2014. Patients had continuous enrollment with medical and pharmacy benefits for ≥6 months prior to and ≥1 year following the index date. Index date was the point at which any of the following inclusion criteria were satisfied: first psoriasis diagnosis by a dermatologist, ≥2 psoriasis diagnoses ≥30 days apart, or a diagnosis of psoriasis followed by a claim for psoriasis therapy. Of primary interest was to measure and describe the following psoriasis treatment patterns: utilization rates, time to treatment discontinuation, and lines of therapy for various therapeutic classes of pharmacologic therapies. From the 128,308 patients identified, 53% were female, mean ± SD age was 50 ± 16 years, with median 3 years follow-up. Topicals were received by 86% of patients, non-biologic systemics by 13%, biologics by 6%, photothe...
Journal of managed care & specialty pharmacy
Sustained Virologic Response and Costs Associated with Direct-Acting Antivirals for Chronic Hepatitis C Infection in Oklahoma Medicaid
2018 •
David Thompson
Outcomes involving newer direct-acting antiviral (DAA) hepatitis C virus (HCV) regimens have not been studied extensively among the Medicaid population. To assess clinical (treatment failure) and economic outcomes for chronic HCV-infected Oklahoma Medicaid members following treatment with DAAs and to measure associations with patient, treatment, and clinical characteristics. This cross-sectional study used Oklahoma Medicaid pharmacy and medical claims data for adult members who used a newer DAA agent and had reported a successful or failed sustained virological response rate 12 weeks after therapy completion (SVR12) from January 1, 2014, to June 30, 2016. Multivariable logistic and gamma regressions assessed predictors of SVR12 failure and costs controlling for member demographics (i.e., age, sex, race, rural residence); type of DAA and adherence; clinical characteristics (e.g., comorbid conditions, advanced liver disease); and the implementation of changes to a prior authorization ...
756 Association Between Cardiometabolic Risk Factors and Body Mass Index Based on Diagnosis and Treatment Codes in an Electronic Medical Record Database
2008 •
Shawn Burke
BACKGROUND: Managed care organizations (MCOs) have access to treatment and diagnosis information from administrative claims data but generally have limited or no access to clinical information about laboratory values or biometric values such as body mass index (BMI) or waist circum- ference. Thus, MCOs are generally unable to identify overweight patients with cardiometabolic risk factors that put them at a
Journal of managed care & specialty pharmacy
Medication therapy management programs: promises and pitfalls
2014 •
Henry Carretta
Medication therapy management (MTM) is one form of a medication benefit program offered by public and private health providers and insurers. Although the term was first coined in 2003, MTM in its earlier forms has been used since the 1990s as a mechanism to improve health metrics for medically complex patients. Its role expanded with the passage of Medicare Part D, as a mandated component to help patients with multiple chronic conditions, high drug costs, and high utilization to improve the effectiveness and safety of their medication treatments. To review the evidence on MTM effectiveness in order to (a) provide information on its establishment and goals and (b) summarize research findings under 3 outcomes: economic, clinical, and humanistic. PubMed, a search engine service of the National Center for Biotechnology Information was utilized by trained research assistants to search for articles with the following key words: MTM, randomized controlled trials on MTM, evaluation of MTM...
Journal of managed care pharmacy : JMCP
Outcomes of a rheumatoid arthritis disease therapy management program focusing on medication adherence
2010 •
Ann Harada
A national pharmacy benefits management company implemented a rheumatoid arthritis (RA) disease therapy management (DTM) program as an enhanced offering to patients receiving specialty pharmacy services. The program was designed to improve medication adherence, maximize therapeutic outcomes, and enhance physical functioning and health-related quality of life (HRQOL) by empowering patients and improving their knowledge of RA. To evaluate (a) adherence to injectable RA medications for patients participating in an RA DTM program compared with nonparticipating patients receiving injectable RA medications at specialty or community pharmacies and (b) HRQOL, work productivity, and physical functioning before versus after completing the RA DTM program. Patients who had an RA diagnosis and a pharmacy claim for an injectable RA medication during the identification period (August 2007 through September 2008) and were continuously enrolled with the plan from 4 months before through 8 months aft...
362 Comparison of Rates of Potentially Inappropriate Medication Use According to the Zhan Criteria for VA Versus Private Sector Medicare HMOs
2006 •
Shawn Burke
BACKGROUND: Inappropriate prescribing in the elderly is common, but rates across different health care systems and the impact of formulary restrictions are not well described. OBJECTIVE: To determine if rates of inappropriate medication use in the elderly differ between the Veterans Affairs (VA) health care system and the private sector Medicare health maintenance organization (HMO) patients. METHODS: A cross-sectional study
43 Higher Costs and Therapeutic Factors Associated With Adherence to NCQA HEDIS Antidepressant Medication Management Measures: Analysis of Administrative Claims
2006 •
Joseph Johnston, Ralph Swindle
2-5 This study examines factors associated with adher- ence to national treatment guidelines, including investigations of the impact of antidepressant and initial dosage level on adherence measures and costs. An estimated 16% of the costs of antidepressant treatment were found to be associated with patients who were never adequately treated. 4 Inadequate dose and duration of anti- depressant treatment has
